Nighttime incontinence - advice

[MissDiane]

Hi, mum has very recently moved to an EMD home from having spent 1 year in a rest home.

She has adapted to the new home very well on the whole, but recently has been having night time incontinence which is new for mum.

This has resulted in all sorts of problems, with carers having to come in three times in the night to sort it out.

On my suggestion to the manager, we tried mum wearing a pad, but the carer came in to change it in the middle of the night which resulted in some aggression from mum. And mum tells me the carer was not too happy having been in 3 times to change the bed etc.

I'm told an incontinence assessment takes 6 weeks. The Rapid Intervention team have been called due to mum lashing out in the middle of the night.

She is very anxious about going to bed in case she has an accident.

Is it necessary for carers to come in an change her when she is going to be sleeping, confused, frightened and upset?

Can they speed up the continence assessment?

Mum is still on a trial period at the new home and we were told any aggression would not be tolerated. I am keen to find a solution asap.

 

[Beate]

I'm a bit confused - she's in a care home but they don't know how to deal with incontinence? How dare the carer have an attitude about how often he has to attend to someone? That's shameful - it's his job! I would lash out too if a stranger woke me in the middle of the night to change my underwear! She was probably frightened like anything! Any aggression will not be tolerated? They caused it! What kind of care home is this? Get her out of there pronto, they don't seem very caring or understand dementia. Honestly, I'm shocked.

If your Mum does not want to be woken in the middle of the night to be changed she shouldn't have to be, but of course it means she'll lie in a wet pad considerably longer. When I put my OH in respite I made it a condition of the care plan that he is not woken at night, but I had to provide my own Kylie sheets to soak most of it up. Care homes don't like to be accused of neglect so they tend to check people every two hours and change them when needed, without any concern for their broken sleep. Some PWDs don't mind this but some do, and that should be acknowledged. If your Mum is not averse to a morning shower and skin breakdown can be prevented with barrier cream, she will not suffer any lasting damage by sleeping in a wet pad.

If I was you, I would cause a stink about this.

 

[MissDiane]

Thank you for your prompt reply. The problem I am finding is that professionals don't want to stick there neck out and tell care homes they need to do things differently. This is why we had to leave the last home because they were neglecting mum, and although social services acknowledge there were many things the home should have done differently, they won't stick there necks out and deal with it. They won't put the recommendations in writing. Although I keep asking. Even the RIP team who are supposed to liaise with the home don't seem to have the bottle to sort out these things. I'm not pushy, but I do speak up, but often feel unheard. I need someone to help me but when I turn to the professionals I feel let down. Maybe I should ask to review her care plan and stipulate these things like not to wake her etc. I'm just scared of making a fuss as this may result in having to move her again which makes me mad as the last time it was due to failings at the home. Its not mums fault. I was made to feel like a trouble maker last time, it was very unpleasant in the end.

 

[Jessbow]

\would she tolerate pull ups for nigh time?

 

[MissDiane]

Yes I'm sure that would be fine, but they are telling me it takes 6 weeks for an assessment to get mum allocated the products. In the meantime they said they have some spare pads she can use.

Maybe I can buy some myself. I did offer this as an interim solution but they didn't take it on.

 

[Beate]

Whether you buy them yourself or not, she'll still wake up when changed.

Have you thought of getting an advocate from the Alzheimer's Society of the Carers Centre to fight your corner for you?

 

[MissDiane]

I tried the carer's trust and after being passed from pillar to post I was told there was a long waiting list for an advocate, and then in the end they said I had to get social services to put a referral in. So it all seemed like hard work and I needed their help asap not in 6 weeks!

But I could try the Alzheimer's society.

 

[Louby65]

Hello miss Diane . My mum has incontinence and after assessing many pads I eventually got the right ones for her . During the day she wears pull ups and overnight she wears an all in one pad that has varying amounts of liquid held , depending on which one is more suitable . I went for one that had a stay dry barrier and deep core which ensures the urine is soaked up well and the skin has very little urine on it . I have been using them for over 2 years and my mums skin is perfect . Because I use pads that have maximum absorbency , it reduces the need to change the pad . If she wakens herself during the night I wash her with baby wipes and change her pad . If she doesn't waken I leave her till the morning . This could maybe be the best option for your mum. I pay for these pads myself as they seem better for her skin . If you wish any details of the pads I use feel free to pm me and I will send you the details . Best wishes . Lou